1. Conductive and Convective Heating Muthiah Munawwarah

3. Heat Exchange by Conduction Perpindahan energi panas melalui molekul dengan cara adanya energi kinetik yang berbenturan dari molekul Conductivity air lebih baik dari lemak. Sumber conductive heating meliputi: electic heating pads, thermal water baths, contras baths, hot packs, and paraffin wax

4. Hemodynamic effect Vasodilatation Cellular –  temperature   cell metabolism   O 2 ; cell waste  excreted  temperature  blood hemoglobin releases O 2 (106°F = twice as much O 2 released)  temperature  (104°-113°F) plastic deformation of collagen-rich tissues occurs more easily Blood & Fluid Dynamics –  b. flow   edema, but  b. flow removes wastes, etc. Triggers release of bradykinin

6. Hydrocollar Packs Merupakan kain berisi silical gel, yang di celupkan ke dalam stanless stell tank air dengan temperatur 76-80C selama 30-40 mnt. Digunakan untuk relaksasi dam muscle spasm superficial

8. Biological effect Penetrasi Hydrocollar tidak sedalam Infra red, Infra Red memiliki penetrasi 0.5-1mm Hyperaemia: increase vasodilatation open arteriovenous anastomosis Increase ini flow of nutrients, antibodies, leucocytes, oxygen to the tissue Release histamin and bradikinin producing vasodilatation of capillaries Increase vasodilatation of superficial fascia and muscle Decrease gamma fibre activity of the muscle spindle Reduce conduction velocity of the C nerve fibres

9. Indication Hydrocollar Packs Pain and Muscle Spasm: Superficial with increase circulation than reduction of nerve conduction velocity of the pain nerve fibre. Inflammation: Mild Inflamation, increase phagocytosis Oedema: cronic stage with increase permeability of cell membrane bring fluid from the tissue to the venous and lymphatic vessel

10. Contra indication for hydrocollar packs Impaired skin sensation Circulatory dysfuntion: vericose veins, deep trombosis Infection and open wounds Cancer or tuberculosis Advantages and Disadvantages Easy to apply, sedative effect Not easy applied around shoulder and hips

11. Lilin yang di cairkan di tangki pemanas Wax has slow thermal conductivity Use has melting point 52-54c Should be changed every six months. Paraffin Wax

13. Physiological Response Increase in skin temperature up to 12-13c, in subcutaneous fascia there is an increase of 5c, in superfisial muscle there is only 2-3c Superficial capillaries and arteioles caused local hyperaemia and reflek vasodilatation, Vasodilatation in the muscle are negligible. Exercise after wax is essential to increase muscle circulation, and to use the sedative effect of heat to obtain ROM and Muscle Stength. Sedative effect on the tissue Wax leaves the skin moist, soft and pliable, this is useful for stretching scars and adhesions before applying mobilisation techniques.

14. Indication Pain and Muscle Spasm. Oedema and Inflammation. Swelling in hands affected by rheumatoid arthritis or degenerative joint disease, and early cronic stages of inflammation Adhesion and scars. Wax softens the adhesion and scars in the skin thus fascilitates the mobilisation and stretching procedures

15. Contraindication Impaired skin sensation Dermatological condition: eczema, athlete’s foot Circulatory dysfunction: varicosa veins, deep vein thrombosis and arterial disease Analgesic drugs: use strong narcotics for pain Cancer or tuberculosis: heat increasing metabolic, may increase the rate of growth and spread of the disease

16. Contrast Bath Method of applying heat and cold water to control the normal body temperature regulating mechanism Two baths one with hot water 40-45C, and the other cold water at 15C The treatment should begin and end with hot water Procedure should not take more than 15 minutes Marked vasodilatation, an increase of deeper circulation, an marked sedative effect.

18. Summary Conductive heating by means of steam pack, paraffing, and contrast baths is cheap, quick and effective way of providing moist heat to allieviate pain, muscle spasm, The biological effects of conductive depend tissue, time radiated, pathophysiology of the tissue, and ability the tissue to dissipate heat. Maximum penetration is only dermis level Heat is transmitted by movement in mass in a liquid or a gas. The transfer of heat is by conduction from the molecular of fluid to the surface

19. Neuromuscular effect Changes in nerve conduction velocity and firing rate  chemical reactions & cell metabolism  nerve conduction Pain Control –  circulation   congestion in area Mechanical pain  by reducing pressure on nerves (swelling is removed) Analgesic effect

20.  aktivitas enzim pada suhu 39 o -40 o C   reaksi biokimia sell, oksigen, & pemulihan (healing) Metabolic effect Increased metabolic rate

21. Kenaikan suhu akan meningkatkan extensibilitas pada jaringan. Ketika jaringan di beri pemanasan sebelum dilakukan stretching, akan terjadi peningkatan yg lebih ketika stretching dan akan mencegah kesobekan jaringan Altered tissue extensibility effect Increased colagen extensibility